Doctors recommend early treatment for osteoarthritis before it spreads throughout the body. / Gregorio Borgia, AP

by Janice Lloyd, USA TODAY

by Janice Lloyd, USA TODAY

Arthritis pain that begins slowly in one joint and is left untreated can eventually wallop the entire body, leading to disability and costly surgeries, researchers reported Sunday.

Studies being discussed at the American College of Rheumatology's annual meetings in Washington, D.C., through Wednesday find that when osteoarthritis progresses to multiple joints it can cause havoc by triggering pain everywhere in the body from head to toe. New ways of managing the disease affecting 27 million Americans can prevent the crippling pain from spreading and improve overall health, according to Joanne Jordan, chairman of the U.S. Bone and Joint Initiative's Chronic Osteoarthritis Management Initiative.

"We need to treat the pain early on before it gets generalized," says Jordan, director of the University of North Carolina's Thurston Arthritis Research Center. "When pain becomes generalized, things that ordinarily wouldn't hurt are hurtful. For instance, you can pat someone on the shoulder and their shoulder, which might not be near the afflicted joint, will hurt. They'll wince or cry out in pain."

In these patients where the pain has taken on a life of its own, doctors need to "aggressively" treat the pain, she says: "Sometimes a patient will go to the doctor and say they hurt everywhere, and the doctor isn't always sympathetic.

"What we're discovering is the central nervous system rewires itself when pain keeps occurring from one place and generalizes the pain instead to other places in the body."

Jordan says new research finds the pain burden can be relieved by treating it with muscle relaxants and antidepressants, but more therapies need to be developed.

Adam Goode, a researcher at Duke University, presented findings Sunday on how pain perception changes in someone with mid- to severe osteoarthritis. In a study of 1,602 people taking part in the Johnston County (N.C.) Osteoarthritis Project, Goode tested pain thresholds by attaching a dolorimeter to the neck area and applying pressure.

"Compared with people who didn't have any knee or hip symptoms, those who had symptoms in both knees and both hips were 50% more likely to feel that pressure as painful,'' he said.

Specialists at the meeting are targeting solutions to end the pain cycle. The Chronic Osteoarthritis Management Initiative, developed from medical professionals in orthopedics, physical therapy, sports medicine and rheumatology, calls for managing osteoarthritis like other chronic diseases. Tops on the list: prevention. By getting an early diagnosis, people can stay active and reduce their likelihood of having their arthritis worsen other chronic health problems, including obesity, diabetes and heart disease, Jordan says.

"Many doctors assume an inevitable trajectory of aging and osteoarthritis," she says. "And they think joint-replacement surgery will address the problem." This "joint death and rebirth process" can be transformed, she says, by identifying risk factors (knowing if other family members have the disease, identifying risk factors like obesity, having a longer leg, avoiding sports injuries early in life), and doing regular followups.